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Childhood pneumococcal conjugate vaccine (PCV) protects against invasive pneumococcal disease caused by vaccine-serotype (VT) Streptococcus pneumoniae by generating opsonophagocytic anti-capsular antibodies, but how vaccination protects against and reduces VT carriage is less well understood. Using serological samples from PCV-vaccinated Malawian individuals and a UK human challenge model, we explored whether antibody quality (IgG subclass, opsonophagocytic killing, and avidity) is associated with protection from carriage. Following experimental challenge of adults with S. pneumoniae serotype 6B, 3/21 PCV13-vaccinees were colonised with pneumococcus compared to 12/24 hepatitis A-vaccinated controls; PCV13-vaccination induced serotype-specific IgG, IgG1, and IgG2, and strong opsonophagocytic responses. However, there was no clear relationship between antibody quality and protection from carriage or carriage intensity after vaccination. Similarly, among PCV13-vaccinated Malawian infants there was no relationship between serotype-specific antibody titre or quality and carriage through exposure to circulating serotypes. Although opsonophagocytic responses were low in infants, antibody titre and avidity to circulating serotypes 19F and 6A were maintained or increased with age. These data suggest a complex relationship between antibody-mediated immunity and pneumococcal carriage, and that PCV13-driven antibody quality may mature with age and exposure.

Original publication

DOI

10.1016/j.vaccine.2022.09.069

Type

Journal article

Journal

Vaccine

Publication Date

28/11/2022

Volume

40

Pages

7201 - 7210

Keywords

Avidity, Carriage, Colonisation, Opsonophagocytosis, PCV, Pneumococcal conjugate vaccine, Pneumococcus, Humans, Child, Infant, Adult, Child, Preschool, Streptococcus pneumoniae, Antibody Formation, Pneumococcal Vaccines, Pneumococcal Infections, Vaccines, Conjugate, Vaccination, Immunoglobulin G, Nasopharynx